Chronic obstructive pulmonary disease in over 16s: diagnosis and management. [10]. Shea BJ, Reeves BC, Wells G, et al. However, there is wide variation in models of service delivery, and evidence to understand which elements are most effective is less clear. [1]. The Global Impact of Respiratory Disease – Second Edition. We will resolve all conflicts through discussions to reach a by a third party. Epidemiology of chronic obstructive pulmonary disease: prevalence, morbidity, mortality, and risk factors. 1–7. The primary instructions of these guidelines are as follows: (1) The short-term goal of pulmonary rehabilitation is to alleviate … Nolan CM, Kaliaraju D, Jones SE, et al. Research Article: Study Protocol Systematic Review. Pulmonary rehab is a multi-disciplinary programme and one of the key recommended approaches in the … Kurtaiş Aytür Y, Köseoğlu BF, Özyemişçi Taşkıran Ö, Ordu-Gökkaya NK, Ünsal Delialioğlu S, Sonel Tur B, Sarıkaya S, Şirzai H, Tekdemir Tiftik T, Alemdaroğlu E, Ayhan FF, Duyur Çakıt BD, Genç A, Gündoğdu İ, Güzel R, Demirbağ Karayel D, Bilir Kaya B, Öken Ö, Özdemir H, Soyupek F, Tıkız C. Turk J Phys Med Rehabil. Chapter 1: Introduction. [22]. The screening of systematic reviews, eligibility evaluation, data extraction, methodological quality, and quality of evidence will be performed in pairs by independent reviewers. Pulmonary Rehabilitation (PR) Services – JA6823 . This guideline covers diagnosing and managing chronic obstructive pulmonary disease or COPD (which includes emphysema and chronic bronchitis) in people aged 16 and older. An Official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation e an executive summary. Adults (18 years of age or older) without any restrictions based on the severity of the disease or in the exacerbated state. We intend to standardize the reported results if a result is expressed differently between reviews. Pulmonary rehabilitation – accreditation. PhDb; Souza, Bruma M.M. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. The joint ACCP/AACVPR Evidence Based Guidelines regarding PR released in May 2007 provides a systematic, evidence-based review of the pulmonary rehabilitation literature that updates the 1997 ACCP/AACPR guidelines. Visualization: Karla Morganna Pereira Pinto Mendonça, Brenda Nazare Gomes Andriolo, Patricia Angelica Miranda Silva Nogueira. The results reported in the included reviews will be summarized in an “Overview reviews” table by result and then by comparison. For this, the results of included studies will be interpreted by the reports made in the reviews, without having to resort to the original data of the study. Rossi A, Butorac-Petanjek B, Chilosi M, et al. Your message has been successfully sent to your colleague. NCI CPTC Antibody Characterization Program. Any control considered for comparison in individual systematic reviews. [35]. All protocols for revisions will be noted in the “Studies awaiting evaluation” section for possible inclusion in future updates of this overview. Respir Res 2019;20:89. Chinese Association of Rehabilitation Medicine; Respiratory Rehabilitation Committee of Chinese Association of Rehabilitation Medicine; Cardiopulmonary Rehabilitation Group of Chinese Society of Physical Medicine and Rehabilitation. For medical necessity clinical coverage criteria, see MCG ™ thCare Guidelines, 24 edition, 2020, Pulmonary Rehabilitation, ACG: A-0372. [17]. The following results were analyzed: health-related quality of life, functional capacity, mortality, dyspnea, cost-effectiveness, and adverse events. Many recommendations have been retained or their validity has been reinforced; however, new data have extended or modified our … Whiting P, Savović J, Higgins JP, et al. Please enable it to take advantage of the complete set of features! Search for Similar Articles Pulmonary rehabilitation, cardiac rehabilitation, and intensive cardiac rehabilitation … Pulmonary Rehabilitation – Department of Vermont Health Access. Project administration: Zenia Trindade de Souto Araujo, Patricia Angelica Miranda Silva Nogueira. Since then, the published literature in pulmonary rehabilitation has increased substantially, and other organizations have published important statements about pulmonary rehabilitation (eg, the American Thoracic Society and the European Respi-ratory Society4). methods The Guideline methodology adhered to the Appraisal of Guidelines for Research and Evaluation (AGREE) II criteria. For data presented as standardized mean difference (SMD), with or without 95% confidence intervals (CI) or level of significance (P value), Cohen interpretation[43] will be useful to define the effect size. How to cite this article: Araujo ZT, Mendonça KM, Souza BM, Santos TZ, Chaves GS, Andriolo BN, Nogueira PA. Such as disease severity (stable vs exacerbation); age, and location where pulmonary rehabilitation was offered (hospital, rehabilitation center, home). A recent epidemic of pneumonia cases in Wuhan China was caused by a novel coronavirus with strong infectivity, the 2019 novel coronavirus (2019-nCoV). The article in this overview will be submitted for publication in a peer-reviewed journal. Siddiq MAB, Rathore FA, Clegg D, Rasker JJ. The searches will be conducted in the Cochrane Systematic Reviews Database (CDSR), in the Cochrane Library. may email you for journal alerts and information, but is committed Published by Wolters Kluwer Health, Inc. Health-related quality of life (HRQoL) (measured by Saint George's Respiratory Questionnaire, Clinical COPD Questionnaire, 36-Item Short Form Health Survey questionnaire, COPD Assessment Test, or any validated instrument); Functional capacity (measured by cardiopulmonary exercise test—CPET; shuttle walk tests—SWTS; 6 minute walk test—6MWT, or any other validated instrument); Dyspnea (as measured by MRC, Borg, or any other validated instrument); Adverse events (hospitalizations, absenteeism, at work, exacerbations). [1,9,19] Pulmonary rehabilitation can be performed in different settings, such as: hospital, outpatient clinic, or home. We will use the evaluations of the Classification of Recommendations, Evaluation, Development and Evaluation (GRADE) of the authors of the included systematic reviews. [9]. [1–4] The diagnosis requires confirmation by spirometry (FEV1/FVC ≤ 70% post-bronchodilator or FEV1/FVC ≤ 70% and FEV1 < 80% pre-bronchodilator—where post-bronchodilator testing is not possible) and history of exposure to particulate matter or harmful gases. [33]. This analysis outlines key elements of an occupational therapy-led pulmonary rehabilitation programme. Your PR team will be made up of trained health care professionals such as physiothera… While the guidelines do not recommend pulmonary rehab during the hospital stay itself, they do recommend beginning such a program within three weeks of discharge. Applicable Codes Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website ( Any disagreements will be resolved through discussion in the overview authors team. Pulmonary rehabilitation (PR) is made up of: 1. a physical exercise programme, designed for people with lung conditions and tailored for you 2. information on looking after your body and your lungs, and advice on managing your condition and your symptoms, including feeling short of breath It’s designed for people who are severely breathless. They also recommend a home-based management approach for patients who present to the hospital or emergency department with a COPD exacerbation. esperança, 189 Apt. This equates to 150,924 fewer exacerbations, freeing up this number of appointments in primary care. Cardiovascular and Pulmonary Rehabilitation (AACVPR). BMC Health Serv Res 2004;4:1–7. Writing – review & editing: Zenia Trindade de Souto Araujo, Karla Morganna Pereira Pinto Mendonça, Bruma Morganna Mendonça Souza, Tacito Zaildo Morais Santos, Gabriela Suellen da Silva Chaves, Brenda Nazare Gomes Andriolo, Patricia Angelica Miranda Silva Nogueira. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) works with health care professionals and public health officials to raise awareness of Chronic Obstructive Pulmonary Disease (COPD) and to improve prevention and treatment of this lung disease for patients around the world. Available at: [36]. Estimates of effect of included systematic reviews, categorized by intervention and primary and secondary outcomes, will be extracted and presented in tables and figures. PVD15448-2018). Puhan MA, Gimeno-Santos E, Cates CJ, et al. Validation: Karla Morganna Pereira Pinto Mendonça, Bruma Morganna Mendonça Souza, Brenda Nazare Gomes Andriolo, Patricia Angelica Miranda Silva Nogueira. Epub 2020 Sep 20. Is a pulmonar rehabilitation program effective in COPD patients with chronic hypercapnic failure? Pulmonary rehabilitation is a restorative and preventative process for patients who are diagnosed with a chronic pulmonary disease. 2020 Aug;48(8):300060520948382. doi: 10.1177/0300060520948382. Eur Heart J 2019;Aug 31:[Epub ahead of print]. J Clin Epidemiol 2016;69:225–34. 2019 novel coronavirus; Pneumonia; Pulmonary rehabilitation. Chronic thromboembolic pulmonary hypertension (group 4) 10.1 Diagnosis 10.2 Therapy 10.2.1 Surgical 10.2.2 Medical 10.2.3 Interventional 11. The risk of bias will be assessed by the Risk of Bias in Systematic Reviews (ROBIS). Version 2.56, December 2018. Negewo NA, Gibson PG, McDonald VM. Watz H, Pitta F, Rochester CL, et al. [39] We will present in a Table 3 the assessment of individual ROBIS items or domains (along with justification for judgments for each evaluation—relevance, identification of potential bias risks during the review process, and general bias risk). [24]. Available from Cochrane Community. Importance of the relationship between symptoms and self-reported physical activity level in stable COPD based on the results from the SPACE study. However, it is not known which PR components are essential, such as duration, ideal locations, type and intensity of training, degree of supervision, adherence, cost-effectiveness challenge, and how long the program effects last. Lippincott Journals Subscribers, use your username or email along with your password to log in. [12–15] These factors have a major impact on health and economy and make it a major challenge for managers. London: Cochrane; 2018;Accessed August 2, 2019. COVID-19 is an emerging, rapidly evolving situation. Emphasis is given to the physical training that can be performed in groups, but with individualized sessions that involve aerobic, resistance, interval or continuous exercises, resistance/strength, flexibility, neuromuscular electrical stimulation, exercises that involve the upper and lower limbs, in addition to inspiratory muscle training. For the purposes of this overview, systematic reviews evaluating pulmonary rehabilitation including physical training (e.g., aerobic exercise, resisted exercise or aerobic, and resisted exercise) will be included; educational component and/or psychological support such as intervention. [4]. The results that have been reported in the included reviews will be summarized in an “Overview of Reviews” table. [39]. PhDg, aLaboratory of measures and evaluation in health, bPostgraduate Course in Physiotherapy of the Federal University of Rio Grande do Norte, Natal, Brazil, dLaboratory of evaluation and respiratory intervention, Department of Physiotherapy, eSchool of Kinesiology and Health Science, York University, Toronto, Canada, fCochrane Brazil, Center for Evidence-Based Health Studies and Technology Assessment in Health, São Paulo. [32]. [26]. Data curation: Zenia Trindade de Souto Araujo. Investigation: Zenia Trindade de Souto Araujo, Patricia Angelica Miranda Silva Nogueira. [3]. Int J Chron Obstruct Pulmon Dis 2017;12:2593–610. Eur Respir J 2019; 54: 1900382. • BTS Pulmonary Rehabilitation Guidelines (2013) The new PR Guidelines are currently under review and are expected to be released in Autumn 2020. This overview seeks to assess the evidence published in Cochrane original systematic reviews and will not attempt to update these reviews. [29]. The authors have no conflicts of interest to disclose. Chronic obstructive pulmonary disease (COPD) is a frequent disease, determined by constant respiratory symptoms and chronic airflow limitation. doi: 10.3760/cma.j.issn.1001-0939.2020.0004. ∗Correspondence: Zênia T.S. We will standardize as differences (MDs) or differences of standardized means (SMDs) using equations published in the Cochrane Handbook for Systematic Reviews of Interventions for continuous results.[40]. Abbreviations: AMSTAR-2 = Assessment of Multiple Systematic Reviews-2, COPD = chronic obstructive pulmonary disease, GRADE = Classification of Recommendations, Evaluation, Development, and Evaluation, PR = pulmonary rehabilitation, RCTs = randomized controlled trials, ROBIS = risk of bias in systematic reviews, SR = systematic reviews. Eur Respir J 2017;49:1–6. Prevalence of comorbidities in chronic obstructive pulmonary diseasepatients: a meta-analysis. Results tables will include effect estimates, with 95% confidence intervals (CIs), and measures of heterogeneity/risk of bias, as appropriate. However, specific information on intervention components can be requested from test reports and individual researchers. Cochrane Database Syst Rev 2015. Pulmonary rehabilitation for chronic obstructive pulmonary disease. COPD Guidelines for health care professionals. Metabolic and anti-inflammatory effects of a home-based programme of aerobic physical exercise. Araujo, Av. 2019;98:38(e17129). The results will be represented in the “Summary of findings” Table 4. Pulmonary rehabilitation is proven and medically necessary in certain circumstances. CTS GUIDELINES AND POSITION PAPERS Quality indicators for pulmonary rehabilitation programs in Canada: A Canadian Thoracic Society expert working group report Gail Dechmana, Walden Cheungb,c, Christopher J. Ryersonb,d, Paul Hernandeze, Michael Sticklandf,g, Andrea Gershonh,i,j,k, Darcy D. Marciniukl, Mohit Bhutanim, and Pat G. Campb,c aSchool of Physiotherapy, Dalhousie … Physical activity and clinical and functional status in COPD. The main conclusions about the effects of the interventions studied in the included reviews will be summarized and organized around clinically significant categories (e.g., types of interventions or types of outcomes). COPD and its comorbidities: impact, measurement and mechanisms. Copenhagen: The Nordic Cochrane Centre; 2014. [14]. [1,6,18,23], Despite all the advances in pulmonary rehabilitation, there are still issues to be improved, as: to increase patient access to rehabilitation programs around the world; to understand effects during hospitalization due to exacerbation and/or after early exacerbation (within 1 month of exacerbation); benefits in the early stage of COPD (mild disease); alternative models of pulmonary rehabilitation (use of new technologies, telerreabilitation, home rehabilitation, use of minimal equipment or without equipment, self-management); degree of supervision; intensity of exercises; ideal time, and duration of the effects of rehabilitation.[18,34]. here ™ to view the MCG Care Guidelines. Available at: [6]. Supplemental digital content is available for this article. Home versus outpatient pulmonar rehabilitation in COPD: a propensity-matched cohort study. Available from [13]. The narrative descriptions of the estimates of the effects of the included revisions will be structured according to the risk of systematic review bias and GRADE evaluation. British Thoracic Society guideline on pulmonary rehabilitation in adults. Respirology 2017;22:800–19. Keywords: Araujo, Zênia T.S. 10. Am J Respir Crit Care Med 2013;188:13–64. Data extraction from each included revision will be performed independently by 2 authors (ZTSA and TZMS) using Review Manager 5.3.5 (the Cochrane Collaboration, London, United Kingdom). We will discuss the limitations of currently available evidence regarding heterogeneity of inclusion criteria for each review, consistency of effect size for each intervention, and consistent use of outcome measures. We will summarize this information in accordance with the guidelines provided in the Cochrane Handbook for Systematic Reviews of Interventions. Yang IA, Brown JL, George J, et al. PLoS One 2014;27:e101228. Formal analysis: Zenia Trindade de Souto Araujo, Gabriela Suellen da Silva Chaves. The search strategy is presented in Supplementary Digital Content (Appendix 1, Effective Date: January 1, 2010. We will standardize risk indices (RRs) or odds ratios (ORs) for dichotomous outcomes. Sheffield, European Respiratory Society; 2017. [18]. Review Manager (RevMan) [Computer program]. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. If the data are reported as a mean difference (MDs) or as an absolute or relative change score, appropriate scales (when possible) will be considered to determine if this was clinically significant. (2014). Rosenberg SR, Kalhan R, Mannino DM. Keyword Highlighting GRADEpro GDT: GRADEpro Guideline Development Tool [Software]. ( Int J Clin Pract 2013;67:1247–53. Medicine. Cardiac and Pulmonary Rehabilitation Programs. Overlapping and discrete aspects of the pathology and pathogenesis of the emerging human pathogenic coronaviruses SARS-CoV, MERS-CoV, and 2019-nCoV. Draft version (8 October 2018) for inclusion. Pollock M, Fernandes RM, Becker LA. Home-based rehabilitation for COPD using minimal resources: a randomised, controlled equivalence trial. This criterion includes coverage provisions for CR, ICR, and PR items and services, physician standards, required components, and limitations to the sessions that may be covered. “Pulmonary rehabilitation implemented within three weeks after … British Thoracic Society Pulmonary Rehabilitation Guideline Development Group; British Thoracic Society Standards of acre Committee. doi: 10.3760/cma.j.issn.1001-0939.2020.03.007. The table should include beneficial and detrimental results, frequency or severity of these outcomes in the control groups, estimates of relative and absolute effects of interventions, bias risk indications (which may vary by outcome and comparison), and comments if necessary. HHS Wolters Kluwer Health Zhonghua Jie He He Hu Xi Za Zhi. Ethical approvals and patient consent are not required, as this overview will be based on a published systematic review. Epub 2020 Aug 10. The role of exercise and PGC1α in inflammation and chronic disease. [31]. Key Words. Systematic reviews that evaluated pulmonary rehabilitation including physical training (e.g., aerobic exercise, resisted exercise or aerobic, and resisted exercise); educational component and/or psychological support such as intervention. 106,532 hospital bed day** 4. to maintaining your privacy and will not share your personal information without COPD 2019. NLM [11]. [31], Therefore, the benefits of pulmonary rehabilitation in patients with COPD are related to clinical improvement directly reflected in health-related quality of life, dyspnea, fatigue, emotional function, and exercise capacity according to Cochrane systematic review and meta-analysis,[18] as well as the current clinical guidelines. MScd; Chaves, Gabriela S.S. PhDe; Andriolo, Brenda N.G. It is hoped that Cochrane reviews have already addressed these issues. Get new journal Tables of Contents sent right to your email inbox,, September 2019 - Volume 98 - Issue 38 - p e17129,,,, MD_2019_08_30_ARAUJO_MD-D-19-05914_SDC1.docx; [Word] (14 KB), Pulmonary rehabilitation for people with chronic obstructive pulmonary disease: A protocol for an overview of Cochrane reviews, Articles in PubMed by Zênia T.S. Management of COPD exacerbations: a European Respiratory Society/American Thoracic Society guideline. Liu J, Zheng X, Tong Q, Li W, Wang B, Sutter K, Trilling M, Lu M, Dittmer U, Yang D. J Med Virol. Your account has been temporarily locked due to incorrect sign in attempts and will be automatically unlocked in Zenia Trindade de Souto Araujo orcid: 0000-0003-3447-6990. chronic obstructive pulmonary disease; overview; pulmonary disease; pulmonary rehabilitation; therapeutic exercise. [35] Thus, this overview aims to summarize the evidence from the different available models of pulmonary rehabilitation interventions for COPD patients, to identify evidence gaps in the current literature to inform about new titles for systematic review of pulmonary rehabilitation, and to describe pulmonary rehabilitation interventions that patients with COPD. 2. As a highly infectious respiratory tract disease, coronavirus disease 2019 (COVID-19) can cause respiratory, physical, and psychological dysfunction in patients. Nature 2008;454:463–9. Chinese Association of Rehabilitation Medicine, et al. This report contains the full data analysis for each data item from the PR clinical audit and unadjusted benchmarked key indicators for participating services in England, Scotland and Wales. [Recommendations for respiratory rehabilitation of coronavirus disease 2019 in adult]. Methodology: Zenia Trindade de Souto Araujo, Karla Morganna Pereira Pinto Mendonça, Tacito Zaildo Morais Santos, Gabriela Suellen da Silva Chaves. Cohen J. [21]. Management of COPD exacerbations: a European Respiratory Society/American Thoracic Society guideline. Statistical Power Analysis for the Behavioral Sciences. Lancet Respir Med 2017;5:691–706. Effects of respiratory rehabilitation on patients with novel coronavirus (COVID-19) pneumonia in the rehabilitation phase: protocol for a systematic review and meta-analysis. 2020 Nov 9;66(4):480-494. doi: 10.5606/tftrd.2020.6889. These Cochrane reviews point to different models in providing care that involves the traditional inpatient or outpatient model as alternative models in the community or at home. The COPD-X Plan: Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease 2018. [37]. A recent epidemic of pneumonia cases in Wuhan China was caused by a novel coronavirus with strong infectivity, the 2019 novel coronavirus (2019-nCoV). Pulmonary rehabilitation guidelines for patients with COVID-19. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001. You may search for similar articles that contain these same keywords or you may The results will also be included in a doctoral thesis and disclosed in medical conferences. Pulmonary hypertension with unclear and/or multifactorial mechanisms (group 5) 12. J Cardiopulm Rehabil Prev 2018;38:406–10. Pulmonary rehabilitation pathway The NICE guidance22on COPD recommends that pulmonary rehabilitation programmes include multi-component, multidisciplinary interventions, which are tailored and designed to optimise each person’s physical and social performance and autonomy. Medicare pays for Cardiac Rehabilitation (CR), Intensive Cardiac Rehabilitation (ICR), and Pulmonary Rehabilitation (PR) programs if specific criteria are met. This Pocket Guide has been developed from the Global Strategy for the Diagnosis, Management, and Prevention of COPD (2019 Report), which aims to provide a non-biased review of the current evidence for the assessment, diagnosis and treatment of patients with COPD that can aid the clinician. However, if not, it will be considered to contact the original authors for clarification on unit analysis issues that were not reported in the intervention review. BMJ 2017;358:j4008. Int J Chron Obstruct Pulmon Dis 2014;27:871–88. 2020 Mar;55(3):105924. doi: 10.1016/j.ijantimicag.2020.105924. Zhonghua Jie He He Hu Xi Za Zhi. Wedzicha JA, Miravitlles M, Hurst JR, et al. 2019 ESC Guidelines for the Diagnosis and Management of Acute Pulmonary Embolism Developed in Collaboration With the European Respiratory Society (ERS): The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). The article in this overview will be submitted for publication in a peer-reviewed journal. Epidemiology and clinical impact of major comorbidities in patients with COPD. Rabinovich RA, Ardite E, Troosters T, et al. It is an overview protocol that follows the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions.